Tax Due Diligence Intake Form

Tax Due Diligence Intake Form

Client Information
Who is your Tax Prepaer
Do you want to apply for the NO fee Advance (Opting for a no cost Advance ($250, $500 or $1000)
Do you want to apply for the additional fee Advance (With a cost to the Taxpayer (25%,50% or 75% of expected refund))
How do you wish to receive your Refund
Direct Deposit Enter your Routing and Account number
Section 1: Filing Status (Select one)
Filing Status
Full Legal Name:
SSN/ITIN:
Date of Birth:

MonthDayYear
Date
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Spouse Name

First NameLast Name
SSN/ITIN:
Date of Birth:

MonthDayYear
Date
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Section 3: Income Sources (Check all that apply and attach supporting documents)
Income Sources*** Please email all forms to info@jwconsultingandtax.com***
Section 4: Deductions & Adjustments
(Check all that apply **(Email all forms to info@jwconsultingandtax.com)**
Rental Property Income/Expenses
Farm Income
Other (please describe):
Section 5: Credits Eligibility
Check all that apply **( Send all the forms via email to info@jwconsultingandtax.com)**
Section 6: Due Diligence Questions (Required by IRS for Credits like EIC, CTC, HoH, AOTC)
Did the dependent live with you for more than half the year?
Dependent 1

First NameLast Name
Dependent 1 Date of Birth
Dependent 1 Social Security number
Dependent 1 Relationship to you
IRS Assigned IP Pin
Dependent 2

First NameLast Name
Dependent 2 Date of Birth
Dependent 2 Social Security number
Dependent 2 Relationship to you
IRS Assigned IP Pin
Dependent 3

First NameLast Name
Dependent 3 Date of Birth
Dependent 3 Social Security number
Dependent 3 Relationship to you
IRS Assigned IP Pin
Did you provide more than half of their support?
Is anyone else eligible to claim this dependent?
Do you have documentation for residency, relationship, and support?
Are any of your dependents in school or disabled ? If so which one ?
For education credit: Do you have Form 1098-T?
For Head of Household: Did you pay more than half the cost of maintaining the household?
Section 7: Business/Self-Employment (Only if applicable)
Business Name:
EIN:
Nature of Business:
Business Address:
Business Income and Expenses (attach P&L or Expense Worksheet):

**Send via email to info@jwconsultingandtax.com**

If you do not have P&L or expense worksheet we can generate this with you proivded information however the tax fee will increase as this is a seperate service.
Section 8: Compliance & Signature
I affirm that the information provided is true, complete, and accurate to the best of my knowledge. I understand that providing false information may result in penalties.
Do you have an outstanding balance or owe any other entity that will offset your tax refund ? Not sure call 1-800-304-3107
How much do you owe
Taxpayer Signature:
Date:

MonthDayYear
Date
Spouse Signature (if joint):
Date:

MonthDayYear
Date
Tax payer ID

Cancelof
Do you have an assinged IP Pin ? Please provide IRS Assigned IP Pin
Spouse ID

Cancelof
Who can we Thank for referring you ?
Should be Empty:

Tax Due Diligence Intake Form

Section 4: Deductions & Adjustments

Section 5: Credits Eligibility

Section 6: Due Diligence Questions (Required by IRS for Credits like EIC, CTC, HoH, AOTC)

Section 8: Compliance & Signature